Paraneoplastic limbic encephalitis cured with nephron-sparing surgery in a patient with clear cell renal cell carcinoma: a case report. Issue 10 (October 2019)

• Record Type: Journal Article
• Authors: Zhu, Lunfeng; Deng, Xiaolin; Lai, Zhaohui; Xie, Ning; Tan, Wanlong
• Is Part Of: Journal of international medical research. Volume 47:Issue 10(2019)
• Page Start: 5318
• Page End: 5322
• Publication Date: 2019-10
• Subjects: Paraneoplastic limbic encephalitis -- paraneoplastic syndrome -- nephron-sparing surgery -- renal cell carcinoma -- N-methyl-D-aspartic acid antibody -- psychiatric symptom -- case report; Medicine -- Periodicals; Pharmacology -- Periodicals; 610.5
• DOI: 10.1177/0300060519863524
• Languages: English
• ISSNs: 0300-0605

Abstract

Paraneoplastic limbic encephalitis (PLE) in association with clear cell renal cell carcinoma has never been reported in China. We herein describe a 54-year-old man with a 1-week history of headache and a 3-day history of psychiatric symptoms. Slight nuchal rigidity was found by physical examination. Imaging studies of the head were normal. Blood and cerebrospinal fluid antibody testing were both positive for N-methyl-D-aspartic acid antibodies. Subsequent contrast-enhanced computed tomography revealed a 5.2- × 4.2-cm left kidney mass with intense enhancement. Emergent laparoscopic nephron-sparing surgery was successfully performed. Immunohistochemistry revealed clear cell renal cell carcinoma. The patient's status improved after the surgery, and he was discharged after 1 month of hospitalization. At the 6-month follow-up, magnetic resonance imaging showed no recurrence, and the patient was living independently. This case indicates the potential effect of nephron-sparing surgery in the treatment of PLE. Tumor screening should be performed early in patients with suspected PLE. Early surgical resection of the primary tumor can improve patients' prognosis.